Septic peripheral embolization from bacterial and fungal endocarditis

J. A.MD Freischlag, H. A. Asbun, M. M. Sedwitz, R. J. Hye, M. Sise, B. E. Stabile

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10 Scopus citations

Abstract

Arterial embolization is second only to cardiac failure as a potentially lethal complication of acute infectious endocarditis. Embolization may be encountered with increasing frequency due to the prolongation of life afforded by antibiotics and cardiac valve replacement surgery. While distal organs are more often affected, peripheral embolization of the lower extremities is by no means rare. Over a two-year period, we have treated six patients with acute infectious endocarditis who developed lower extremity ischemia. Four patients had Gram positive bacterial endocarditis while two immunosuppressed patients developed fungal endocarditis. Treatment of all six patients included lower extremity embolectomy or bypass grafting and long-term intravenous antimicrobial or antifungal therapy. Cardiac valve replacement was required in all six patients. All lower extremities were successfully reperfused, and no patient required amputation. Although the four patients with bacterial endocarditis survived, the two patients with fungal endocarditis eventually died. In conclusion, aggressive use of arteriography, embolectomy, antimicrobial drugs, and cardiac valve replacement appear to offer the best chance for survival and limb salvage for arterial embolism related to endocarditis.

Original languageEnglish (US)
Pages (from-to)318-323
Number of pages6
JournalAnnals of Vascular Surgery
Volume3
Issue number4
DOIs
StatePublished - 1989
Externally publishedYes

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Keywords

  • arterial
  • Bacterial endocarditis
  • embolism
  • fungal endocarditis
  • peripheral emboli

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Freischlag, J. A. MD., Asbun, H. A., Sedwitz, M. M., Hye, R. J., Sise, M., & Stabile, B. E. (1989). Septic peripheral embolization from bacterial and fungal endocarditis. Annals of Vascular Surgery, 3(4), 318-323. https://doi.org/10.1007/BF03187417